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Rheumatoid Arthritis Program at Penn
Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissue. It can also affect other organs.
The cause of rheumatoid arthritis is unknown. It is considered an autoimmune disease. The body's immune system normally fights off foreign substances, like viruses. But in an autoimmune disease, the immune system confuses healthy tissue with foreign substances. As a result, the body attacks itself.
Rheumatoid arthritis can occur at any age. Women are affected more often than men. Rheumatoid arthritis usually affects joints on both sides of the body equally. Wrists, fingers (but not fingertips), knees, feet, and ankles are the most commonly affected. The course and the severity of the illness can vary considerably. Infection, genes, and hormones may contribute to the disease.
Symptoms
The disease often begins slowly, with symptoms that are seen in many other illnesses:
- Fatigue
- Loss of appetite
- Low fever
- Swollen glands
- Weakness
Eventually, joint pain appears. Morning stiffness, which lasts more than an hour, is common. Joints can even become warm, tender, and stiff when not used in as little as an hour. Joint pain is often felt on both sides of the body.
The joints are often swollen and feel warm and boggy (or spongy) to the touch. Over time, joints lose their range of motion and may become deformed.
Other symptoms include:
- Chest pain when taking a breath (pleurisy)
- Eye burning, itching, and discharge
- Nodules under the skin (usually a sign of more severe disease)
- Numbness, tingling, or burning in the hands and feet
Joint destruction may occur within one to two years after the disease first appears.
Diagnosis
A specific blood test is available for diagnosing rheumatoid arthritis and distinguishing it from other types of arthritis. It is called the anti-CCP antibody test. Other tests that may be done include:
- Complete blood count
- C-reactive protein
- Erythrocyte sedimentation rate
- Joint ultrasound or MRI
- Joint X-rays
- Rheumatoid factor test (positive in about 75% of people with symptoms)
- Synovial fluid analysis
Regular blood or urine tests should be done to determine how well medications are working and whether drugs are causing any side effects.
Treatment
Rheumatoid arthritis usually requires lifelong treatment, including medications, physical therapy, exercise, education, and possibly surgery. Early, aggressive treatment for rheumatoid arthritis can delay joint destruction.
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